| Vincent A Hollister Llc | |
|
41 Mechanic St Windsor CT 06095-2545 | |
| (860) 716-5998 | |
| Not Available |
| Full Name | Vincent A Hollister Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 41 Mechanic St, Windsor, Connecticut |
| Authorized Official Name and Position | Vincent A Hollister (OWNER) |
| Authorized Official Contact | 8607165998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent A Hollister Llc 99 Highland View Dr Somers CT 06071-1557 Ph: (860) 716-5998 | Vincent A Hollister Llc 41 Mechanic St Windsor CT 06095-2545 Ph: (860) 716-5998 |
| NPI Number | 1487116521 |
|---|---|
| Provider Enumeration Date | 04/05/2019 |
| Last Update Date | 04/05/2019 |
| Medicare PECOS PAC ID | 7618200197 |
|---|---|
| Medicare Enrollment ID | O20190617000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487116521 | NPI | - | NPPES |
| 008057276 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Vincent A Hollister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992121644 PECOS PAC ID: 9638492978 Enrollment ID: I20150311000334 |
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